Monday 27 March 2017

Black dogs are labradors


It doesn't happen very often, but when conversation turns toward mental health, I'm sometimes asked about my "Black Dog".

I can see why it became a useful shorthand for depression (first popularised by Churchill, among others).  The black dog follows the person like a shadow, sometimes oppressively so, sometimes so large it shuts out all light and prevents any normal activity whatsoever.  It is an entity outside of the person it visits: the person is pursued by the dog, hunted and hunter.  And then the hound can be chased away, tamed or quietened by various treatments and remedies.

While it's a popular metaphor, it has never been one that I have applied to my own clinical depression.

Point one: I love dogs.  Especially black labs, which is often how the black dog of depression is drawn.  A bit like choosing a baby name ("no it can't be called George because that's the name of my tyrant boss") you can't help the mind associations you have and for me dogs represent fun, comfort, companionship and silliness.

Point two: my depression is not some "thing" that visits me.  It is part of me.  It IS me.

This is the reason that matters.  Because, in my experience, depression cannot be chased away or tamed.  To suggest that I can out run or out fox depression makes no sense. Depression is integral to me, a body part that starts off as a small knot in my chest then grows like a tumour until it encompasses my entire body.

When I'm depressed, I am depression.  There is no me and it, only It.

It is my hand's hesitation to pick up a buzzing phone.

It is my stomach's insistence that it is full, despite not having eaten a proper meal in days.

It is my eyes' reluctance to look my husband in the face.

It is my arms' inability to reach for my son when he is clamouring for a cuddle.

It is my legs' leadenness when asked to move from the sofa.

It is my mouth's paralysis stopping words caught in the back of my throat from ever coming out.

It is everything, and yet nothing.  A big negative void that eventually fills me up to the eyeballs.  I cannot run from or fight it any more than I could gouge out my own heart. Instead I must treat recovery as a more gradual process: slowing filling the void: with words, with actions, and then even further down the line with thoughts and feelings.   The words and actions must come first (CBT 101).  There will always be several weeks - months maybe - when I am going through the motions of life.  But eventually the thoughts and feelings return and the void is filled with my sense of self.

Terms such as "get a grip" and "snap out of it" are not PC but are actually quite accurate to how I get over depressive episodes.  People who know me well tend to know when to push.  What nobody can do is chase away a Black Dog for you, or save you from it: the illness (and the recovery) can only start from within.

Saturday 4 March 2017

A different path to "well being"

It's safe to say I'm not "postnatal" any more.  Not by any stretch mark of the imagination.  The Boy is a thriving four year old and I'm a woman rapidly approaching 40 who happens to be his mum.  He's my reason for everything.  The very air I breathe and all the sustenance I need.  But he's becoming quite an autonomous little person, and that invisible umbilical cord is getting longer by the day.  He's out there in the world: making decisions, voicing his fears and desires, finding out things for himself.

Rather than wist and mope after days gone by, and an obsolete role I can no longer occupy, it's time to move with the times.  I have a job now.  Not perhaps my alma mater's traditional idea of a career, but a vocational job which I love and a position which should grow as the young business expands and progresses.  I'm meeting new people and my days are busy and full.  I love telling the Boy, as I kiss him goodbye at nursery, that mummy is off to work.  I love that feeling of being Kat, just Kat.  Not mummy, not a wife, just part of the team.  The other day I twisted my hair into little knots and put some make up on.  I love serving customers with a smile and having a bit of human interaction that has nothing to do with Fireman Sam or bleeding Paw Patrol.

Sometimes I ache as I limp onto the Northern line at the end of a busy shift.  Sometimes I wonder whether I am too old and too arthritic for such a young person's game.  But I'm not going to give up easily.  This is the start of something really exciting and different and creative and fun.   And whatever physical detriments I may suffer (legacy from a broken femur 8 years ago), the new role is working wonders with my mental health.  What is that "five elements of wellbeing" that researchers came up with? *quick google search*
PERMA
* Positive Emotions (P) –  Feeling positive emotions such as joy, gratitude, serenity, interest, hope, pride, amusement, inspiration, awe and love.
* Engagement (E) – Being fully absorbed in activities that use your skills and challenge you.
* Relationships (R) – Having positive relationships is a universal requirement to well-being.
* Meaning (M) – Belonging to and serving something you believe is bigger than yourself.
* Accomplishment (A) – Pursuing success, winning, achievement and mastery for their own sake.
(Seligman, apparently)
Check, check, check, check and check.  In fact, I would add to that list another P, for Physical activity.  Being on my feet and moving (without having to do monotonous exercise) is great for feeling energised, and in turn happier.

It's not that I couldn't derive feelings of wellbeing from motherhood alone. But it was certainly harder to accomplish: positive emotions were clouded by maternal anxieties and feelings of inadequacy.  Full engagement was hard amidst the monotony of nappy changing and making up bottles.  Relationships - well yes, there is no relationship in the world stronger than that of a parent and baby.  But man oh man, when they are screaming and screaming and giving you nothing but screams it is hard to remember that loving bond!  Likewise Meaning and Accomplishment: clearly nothing in life is more meaningful and important than bringing up baby.  But tell that to the sleep deprived parent facing another morning of a sodding soft play play date and luke warm coffee.

So forgive me, for depositing the child in nursery and taking a slightly more direct path to PERMA well being.  I haven't been this well for years.  It may not last but for as long as my arthritic hip allows I'm taking it.